Ny Dissolution Certificate – Fill Out and Use This PDF

New York State

Department of State

DIVISION OF CORPORATIONS,

STATE RECORDS AND

UNIFORM COMMERCIAL CODE

One Commerce Plaza

99 Washington Ave.

Albany, NY 12231-0001

www.dos.ny.gov

CERTIFICATE OF DISSOLUTION

OF

(Insert Name of Corporation)

Under Section 1003 of the Business Corporation Law

FIRST: The name of the corporation is:

.

If the name of the corporation has been changed, the name under which it was formed is:

.

SECOND: The certificate of incorporation was filed with the Department of State on:

.

THIRD: The name and address of each officer and director of the corporation is:

.

FOURTH: (Check the statement that applies)

The dissolution was authorized at a meeting of shareholders by two-thirds of the votes of all outstanding shares entitled to vote.

The dissolution was authorized at a meeting of shareholders by a majority of the votes of all outstanding shares entitled to vote.

The dissolution was authorized by the unanimous written consent of the holders of all outstanding shares entitled to vote without a meeting.

FIFTH: The corporation elects to dissolve.

X

CERTIFICATE OF DISSOLUTION

OF

(Insert Name of Corporation)

Under Section 1003 of the Business Corporation Law

Filer’s Name and Mailing Address:

Name:

Company, if Applicable:

Mailing Address:

City, State and Zip Code:

NOTES:

1.The name of the corporation and its date of incorporation must be exactly as they appear on the records of the Department of State. This information should be verified on the Department of State’s web site at www.dos.ny.gov.

2.This certificate must be signed by an officer, director or duly authorized person.

3.Attach the consent of the NYS Department of Taxation and Finance.

4.Attach the consent of the New York City Department of Finance, if required.

5.The fee for filing this certificate is $60, made payable to the Department of State.

For DOS Use Only